Double muscle transfer for upper extremity reconstruction following complete avulsion of the brachial plexus

Brachial plexus injuries result in considerable disability. Recent interest in reconstruction of the upper limb following brachial plexus injuries has focused on the restoration of prehension following complete avulsion of th e brachial plexus. This article discusses free muscle transfers for reconst ruction of the upper limb to resolve the difficult problems in complete avu lsion of the brachial plexus. The purpose of this article is to describe th e operative technique of the double muscle transfer for upper extremity rec onstruction following complete avulsion of the brachial plexus and its modi fication and secondary reconstructions based on the personal experiences of the authors.